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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: This amendment is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15. This SPA also includes state attestation that it will submit mandatory Health Home Core Set data pursuant to 42 CFR §§ 437.1O and 437.15.
Summary: Effective March 1, 2021, this amendment implements the 1915 (1) State Plan Option that provides Medicaid Assistance for eligible individuals who are patients in eligible institutions for mental diseases (IMD) in accordance with Section 5052 of Public Law 115-271.
Summary: Limitations on amount, duration, and scope of Medical Care and Services provided to categorically and medically needy; methods and standards for establishing payment rates other types of care to include the covered service “Buprenorphine Enhanced Supportive Medication-Assisted Recovery and Treatment (BE-SMART)” for adults in addition to provider qualifications
Summary: Deletes the obsolete covered service “Community Mental Retardation Clinics” and add “Methadone Clinic Services” for adults as a covered service
